Severe tooth pain worsened or triggered by heat, cold, chewing Mouth traua with bleeding, swelling, or soreness Sjogren’s syndrome Salivary gland stones 6. List appropriate counseling and preventative strategies when self-treating patients with canker sores, minor oral mucosal injury and irritation, tooth hypersensitivity, cold sores, and xerostomia. Canker sores Minor oral mucosal injury and irritation Tooth hypersensitivity Cold sores Xerostomia 7. Identify appropriate patient self-monitoring and follow-up for canker sores, minor oral mucosal injury and irritation, tooth hypersensitivity, cold sores, and xerostomia and when a patient referral to a dentist or another health care provider should occur. Canker sores o Contact MD: Symptoms not better after 7 days of treatment with oral debriding/wound cleaning agent Lesion not healing in 14 days Symptoms worsen with self-treatment Symptoms of systemic infection – fever, rash, or swelling Minor oral mucosal injury and irritation o Follow up with MD/Dentist Symptoms after 7 days treatment Symptoms worsen with self-care Systemic infection symptoms or fever, redness, swelling o Stop when symptoms resolve Usually 7-10 days after initial injury Tooth hypersensitivity Cold sores o Follow up with physician
Lesions do not heal in 14 days Self-treatment doesn’t relieve discomfort Systemic symptoms – fever, malaise, rash, swollen lymph glands Symptoms change or worsen Recurrence despite appropriate self-care treatment Xerostomia Heartburn & Dyspepsia 1. Recognize risk factors that can exacerbate heartburn and/or dyspepsia Certain foods & beverages o Spicy foods, chocolate, coffee, carbonated or caffeinated beverages, fatty foods, peppermint, alcohol, etc. Lifestyle o Overeating o Eating < 2 hours before bedtime o Stress Medications o Aspirin/NSAIDs, theophylline, bisphosphonates, anticholinergic agents, nitrates, chemotherapy, estrogen/progesterone Pregnancy Genetics Certain disease states o Gastroparesis o Scleroderma o PUD o Zollinger-Ellison disease o All of these arem ore likely to cause long-term symptoms than short-term 2. Identify patients that are candidates for self care of heartburn and/or dyspepsia and patients requiring referral to a healthcare provider Exclusion criteria: o Frequent heartburn > 3 burns o Severe heartburn o Nocturnal heartburn o Vomiting blood or coffee ground appearance Symptoms of GI bleed; also may have dark colored stool o Chronic hoarseness, wheezing, coughing, or choking Acid getting all the way up into the throat Could also have difficulty swallowing or feel like they have something in their throat
o Unexpected weight loss May be indicative of some type of cancer o Continuous N/V/D o Chest pain with sweating, shortness of breath, pain radiating to shoulder, arm, neck, or jaw Can be indicative of heart attack o Difficulty or pain swallowing solid food o
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- Spring '14
- Common cold, Oral hygiene, Dental caries, productive cough, xerostomia, Aphthous ulcer